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Home My WebLink About28756-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-29713 Date: 09/16/03 TI{IS CERTIFIES that the building ADDITION Location of Property: 1703 LITTLE NECK RD CUTCHOGUE (HOUSE NO.) (STREET) (HAMLET) Coua~ty Tax M~p No. 473889 Section 103 Block 5 Lot 2.1 Sl~bdivision Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 11, 2002 pursuant to which Building Per~nit No. 28756-Z dated SEPTEMBER 19, 2002 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is DECK ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to JOHN CILIA of the aforesaid building. (OWNER) SUFFOLK COUNT~ DEPARTMENT OF HF~kLT~I API~ROVAL ELECTRICAL CERTIFICATE NO. PLI~BE1LS CERTIFICATION D~rK43 Rev. 1/81 N/A N/A N/A zed ~ignature FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 28756 Z Date SEPTEMBER 19, 2002 Permission is hereby granted to: MARY A T~_NGNEY 1703 LITTLE NECK RD CUTCHOGUE,NY 11935 for : CONSTRUCTION OF A DECK ADDITION AS APPLIED FOR at premises located at 1703 LITTLE NECK RD County Tax Map No. 473889 Section 103 Block pursuant to application dated SEPTEMBER 11, 2002 CUTCHOGUE 0005 Lot No. 002.001 and approved by the Building Inspector to expire on FUIRCH Fee $ 150.00 19, 2004. COPY Rev. 5/8/02 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted to the Building Department with the following: A. For new building or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approvai from Health Dept. of water supply and sewe. rage-disposal (S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Plmming Board Approval of completed site plan requirements. For existing buildings (prior to April 9, 1957) nou-conformiug uses, or bnildings and "pre-existing" land rises: l. Accurate survey of property showing all property lines, qtreets, building and dnusual natural or topographic features. 2 A pIoperly coluplctcd application and cm~scnt to inspect sigocd by thc applicant. Ifa ( cnificale of Occupancy is denied, the Building Inspector shall stztlc the reasons fllerefor m wdting to the applicant. Location of Property:_ / House No. Owner or Owners of Suffolk County Tax Map No 1000, Section C. Fees 1. C'mtificatc of Occupancy New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwellmg $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00, Bushmsses $50.00. 2. Certificate of ()ccupancy on Pm-existing Building - $100.00 3. Copy ofCerlificate of Occupaucy- $.25 4. Updaled Ccrtificalc of Occupaucy- $50.00 5 Temporary Certificate ufOccupancy ResiclcnfiaI $1500, Commercml $15.00 New Construction: Old or Pre-existiog Building: _ ~ (cheek oue) Hanflet Street Subdivision Permit No. ~ Date of Permit. Health Dept, Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ o~O.~,. Block ~ Lot Filed Map, __ __ Lot: _ Applicant: ~o,o/,.~ ~'"7',~, Uoderwriters Approval: Final Certificate: (check one) plicant Signature mw~ ~. so~o~ · ~F~ ~NT:~, NEW ii~ '~ I YOUNG ~ YOUNG BUILDING PERMIT EXAMINER CHECK LIST SCTM!~' DISTRICI: LO0~0, SECTION: . )o ~_, BLOCK: _ ~' , LOT: 2__ .~1 STREET M)DI,[FSS: PROJECT DES CRIPTION ESTI2MATED PROJECT COST: DATE REVIEWED: ~[ /~t~ DATE SL~MITTED:~--/~/Z crrT: ~_m ¢ ~to c4o~ s/q3DIVIS ION: FAST TRACK? SINGLE & SEPARATE CERTIFICATION-REQUIRED? ~,/0 NOTES: ~-- LOTS 40,000SF 100-24 Iot ~ecogni~mn (CREATED before June 30, 1983), UNDER~IZED LOTS FP, OM J4N.1997 100 25 Me~gcr (A nonconfomfing at any t/me afie ZONING DIS~I I£T: .... CONFOILMING? :,' REQ. LOT SIZE: E.5;,(~ ACT. LOT SIZE lu~d3'? REQ. LOT COV. '"7° '~ A(?T. LOT COV. __ ~ ~Q. FRONT ~' PROP. FRONT *$o/~Q S~E ~9o/~ v ACT. S~E /. ~Q. ~_ ~ PROP. ~ ~ ~Q. HEIGHT PROP. HEIGHT WATER FRONT'? ,1,/0 DESCRIPTION: PANEL #: /gt/ FLOOD ZONE:. ,.,v __, ~---- APPROVALS REQUIRED SUFFOLK COUNTY HEALTH. PT: YES o~--~ (BED #):__ DTE: TOWN SEPTIC RECEIPT: Y ~I'/~N] NEW YORK STATE DEC: ~'~5c9n/?~ YES SOUTHOLD TOWN TRUSTEES: YES or~ TOWN ZONING BOARD APPROVAL: YES o~J...,~ TOWN PLAN. BOARD APPROVAL: YES TOWN HISTORICAL PRE (SPLIA): YES NYS ENERGY: YES OP~: EGRESS (18 H min.? 4 sq'~tal)~ VENT (SQ. FT. x 4%) BUll,DING PERMITS OPEN/EXPIRED: BP HAVE PRE CO'S: Y OR N BP NOTES: / / PERMIT #:RI0- -Z / C/O Z- -- -Z / C/O Z- LIGHT (SQ. FT. x 8%) FEE STRUCTURE: FOUNDATION: SF FIRST FLOOR: SF SECOND FLOOR: SF OTHER: SF TOTAL: =>~o 5/ SF SF)= SF X $ =$ SF)= __SF X $ =$ 2. ( SF)- (. +$ +$ +$ = $ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATIONlST [ ] FOUNDATION 2ND [ ] FRAMING [ ] FIREPLACE & CHIMNEY REMARKS: ~__~ [ ] ROUGH PLBG. [ ]~ULATION [ ~]~ FINAL DATE INSPECTOR 765-Z802 BUILDING DEPT. INSPECTION [ ~FOUNDATION 1ST [ ] F~UNDATION2ND [ ~ FRAMING ROUGH PLBG. INSULATION FINAL [ ] FIREPLACE & CHIMNEY REMARKS: TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 wwsv. northfork, net/Southold/ Examined ~{[~ ,20 2 Approved ~/l~ ,20 ~ Disapproved a/c Expiration ~/tc~ ,20Z~ PERMIT NO. Building Inspector BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the folloWing, before applying? Board of Health ~Building Plans planning Board approval '~"~Survey Septic Form N.Y.S.D.E.C. Trustees Contact: to: Phone: 6'~/~) APPLICATION FOR BUILDING PERMIT Date ~/9//,o ,q ,20 INSTRUCTIONS , a. This application MUST be completely f'flled in by typewriter or in ink and submitted to the Building Inspector with 3 sets ~of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or · are'as, and waterways. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such a permit · shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose what so ever until the Building Inspector issues a Certificate of Occupancy. f. Every building permit shall expire if thc work authorized has not commenced within 12 months after thc date of issuance or has not been completed within 18 months 15om such date. If no zouing amendments or other regulations affecting the property have been enacted in the interim, the Building Inspector may authorize, in writing, the extension of the permit for an addition six months. Thereafter, a new permit shall be required. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions, or alterations or for removal or demolition as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. (Signature of applicant or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises fo/fo (As on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builders LicenseNo. Plumbers LicenseNo. Electricians LicenseNo. Other Trade'sLicenseNo. Location of land on which proposed work will be done: House Number Street Hamlet County Tax Map No. 1000 Section Subdivision (Name) JD-g Block _~ Filed Map No. Lot ..~. oo / Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existinguseandoccupancy .f ,.,, ,, /, .,:-~ ~. ~... / b. Intended use and occupancy .F,',,~/~ .-- / Nature of work (check which applicable): New Building. Repair Removal Demolition Estimated Cost If dwelling, number of dwelling units If garage, number of cars Fee Addition Alteration Other Work r~nr- (Description) (To be paid on filing this application) Number of dwelling units on each floor 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front ........ ,. Rear Height. Number of Stories .Depth Dimensions of same structure with alterations or additions: Front Depth. Height Number of Stories Rear 8. Dimensions of entire new construction: Front Height Number of Stories Rear Je~ /TX/? Depth 9. Size of lot: Front Rear .Depth 10. Date of Purchase .f/~ o/o.,~ Name of Former Owner 11. Zone or use district in which premises are situated ,~,-,~ ,',/~-, ~/o 12. Does proposed construction violate any zoning law, ordinance or regulation? YES __ NO / 13. Will lot be re-graded? YES 14. Names of Owner of premises Name of Architect Name of Contractor ~'~.o ,_ ,~'d ,..*.. ~...d .0.07",,6 NO v'/ Will excess fill be removed from premises? YES__ NO _ Address__..c~,~.c..-~/..~,r'//z~.~- Phone No. 5"/l'~'~'Yg'..~.,~lo Address Phone No Address ~"Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO __ * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES__ NO__ * IF YES, D.E.C. PERMITS MAY BE REQUIRED. 16. Provide survey, to scale, with accurate foundation pl.an and distances to property lines. 17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey. STATE OF NEW YORK) SS: COUNTY OFJ;//o/,~- ) ~'~ ~/,,~ ~'.'/.,',~ being duly sworn, deposes and says that (s)he is the applicant (Name of individual si&ming contract) above named, (S)He is the ~' ~,~ ,,a ~ ~- (Contractor, Agent, Corporate Officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this 12-n dayof.~---~Z~t-~ 20 ~ 7~ Notary Public Signature of Applicant <2>